Healthcare Provider Details

I. General information

NPI: 1457283467
Provider Name (Legal Business Name): JOANN KNOX BLACKWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CENTER ST STE 300
HICKORY NC
28601-5036
US

IV. Provider business mailing address

2820 DRUMMOND ST
CONNELLY SPRINGS NC
28612-8504
US

V. Phone/Fax

Practice location:
  • Phone: 828-328-3300
  • Fax: 828-328-9101
Mailing address:
  • Phone: 828-638-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024648
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: